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Table 2 Monetary net benefits for a hypothetical evaluation comparing two novel treatments to standard practice

From: Cost effectiveness of antimicrobial catheters in the intensive care unit: addressing uncertainty in the decision

  Standard practice Treatment A Treatment B Optimal choice
Simulation 1 140 150 160 B
Simulation 2 100 110 120 B
Simulation 3 110 100 100 Standard
Simulation 4 100 150 130 A
Simulation 5 130 120 110 Standard
Average expected net benefit 116 126 124 Standard/A/B = 40%/20%/40%
  1. Results are expressed as monetary net benefits, each simulation is equally likely to be 'true'. Treatment A is associated with the highest expected net benefit (AUD $126), but because the distribution of monetary net benefits is skewed, it is preferred in only 20% of samples. Treatment A is therefore optimal, but the error probability associated with this choice is 80%. This probability is substantially higher than the 5% used for tests of statistical significance. The choice to remain with standard practice still carries a 40% probability of not returning the highest monetary net benefits and could be expected to incur economic costs of AUD $10 (AUD $126 minus AUD $116). The alternative with the highest monetary net benefit is the optimal decision, but that decision can be highly uncertain.